Provider Demographics
NPI:1568018646
Name:MESKOWSKY, TARALYN MARIE (PSYD)
Entity Type:Individual
Prefix:
First Name:TARALYN
Middle Name:MARIE
Last Name:MESKOWSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:MESKOWSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:1871 GARINGTON LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-7203
Mailing Address - Country:US
Mailing Address - Phone:916-622-0358
Mailing Address - Fax:
Practice Address - Street 1:1871 GARINGTON LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-7203
Practice Address - Country:US
Practice Address - Phone:916-622-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32970103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical